Correlation between time from injury to surgery and the prevalence of ramp and hidden lesions during anterior cruciate ligament reconstruction. A new diagnostic algorithm

Vico, G. di; Donato, Sigismondo Luca Di; Balato, Giovanni; Correra, Gaetano; D’Addona, Alessio; Maffulli, Nicola; Rosa, Donato

doi:10.32098/mltj.03.2017.12

Cited by 27 publications

(35 citation statements)

References 5 publications

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“…The diagnosis, by imaging and clinical examination or arthroscopically, of disrupted PMFs remains very challenging [ 18 , 32 ]. Tears of PMFs are present in 80% of patients with an ACL tear or traumatic injury to the PLC [ 8 , 30 , 32 , 35 ]. In symptomatic patients, surgery is the gold standard to manage these injuries [ 21 , 36 ], although the most appropriate surgical technique is still debated [ 3 , 22 , 30 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

The popliteomeniscal fascicles: from diagnosis to surgical repair: a systematic review of current literature

et al. 2021

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Background Popliteomeniscal fascicles (PMF) are considered the posterolateral meniscocapsular extensions which connect the lateral meniscus to the edge of the tibia. PMFs disruption leads to hypermobility of the lateral meniscus with pain and locking sensation. Recognition and treatment of PMFs tear remain very challenging. The aim of this systematic review is to collect and analyse the articles concerning popliteomeniscal fascicle disruption from diagnosis to surgical approach. Methods PubMed, Scopus, Web of Science and EMBASE were searched. Various combinations of the keywords “Popliteomeniscal Fascicles”, “Lateral Meniscus”, “Popliteal Hiatus”, “Posterolateral Corner”, “Tear” and “Surgical Repair” were used. The original literature search identified a total of 85 articles comprising of duplicates. The PRISMA guidilines were followed. Studies in English language and published in peer-reviewed journals were included. Articles with level of evidence I to IV were included Results A total of three articles were included in the qualitative analysis. All the articles included are retrospective case series, with a level of evidence IV. Studies concerning patients with pre-operative imaging MRI and clinical assessment, reporting surgical technique and clinical outcomes assessed by physical examination and/or subjective evaluation scales were analysed. Conclusions MRI and the Figure-4 test allow to assess PMF tears pre-operatively. Arthroscopic evaluation constitutes the gold standard to confirm the diagnosis. Although surgery is considered resolutive for symptoms, there is still controversy about the most appropriate technique. Further higher quality studies are required.

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Section: Discussionmentioning

confidence: 99%

The popliteomeniscal fascicles: from diagnosis to surgical repair: a systematic review of current literature

et al. 2021

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“…Nevertheless, it would be interesting to know the existence of anatomical risk factors for meniscal lesions in high-level sports patients with ACL rupture. In fact, the increased risk of associated meniscal lesions would be a sufficient argument to precisely search a meniscal lesion on a MRI or CT scan and to track down it at the time of the reconstruction of the ACL in order to achieve a targeted suture, especially when it existed a longer time from injury than 6 months before surgery as showed by Di Vico et al [31].…”

Section: Discussionmentioning

confidence: 99%

Anatomic risk factor for meniscal lesion in association with ACL rupture

et al. 2019

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Background To assess anatomic risk factors for meniscal lesions in association with acute ACL rupture. The primary hypothesis was that tibiofemoral anatomic measures will be different in those with and without concomitant meniscus tears. Methods A retrospective review of patients who underwent acute ACL reconstruction in the department was performed. All patients underwent a postoperative CT scan. The concavity and/or convexity on the femur and the tibia were measured by two blinded observers on the sagittal plane with different ratios, and these measures were compared in patients with and without meniscus tears in each compartment. Intra- and inter-rater reliabilities were assessed. Results Four hundred twelve patients (268 males and 144 females) were included from October 2012 to February 2015. One hundred sixty-seven patients had a medial meniscal tear (119 males/48 females), and 100 had a lateral meniscal tear (80 males/20 females). The mean time from injury to surgery was 3 months. The average ICC for all measurements was 0.87 (range 0.82–0.98) indicating good reliability. The medial femoral condyle was noted to be significantly longer than the medial tibial plateau in the sagittal plane in patients with a medial meniscal tear ( p = 0.04), and the lateral femoral condyle was noted to be significantly longer than the lateral tibial plateau in the sagittal plane in patients with a lateral meniscal tear ( p < 0.001). In addition, a less convex lateral tibial plateau was statistically correlated with a higher risk of lateral meniscal tear ( p = 0.001). Conclusions A greater anteroposterior length of the medial/lateral femoral condyle relative to the medial/lateral tibial plateau is associated with an increased risk of meniscal lesions in association with acute ACL rupture. The lateral compartment in the male population appears to be the most at risk. Trial registration Retrospectively registered on May 12, 2016 (CPP sud-est II CAL n°2016-037)

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“…Recent work suggests that many failures in ACLR may be due to the neglect of the meniscus-capsular lesion in the posterior horn of the medial meniscus, or zone IV, also called lesions in the meniscal ramp. 27,28 Di Vico et al 28 evaluated patients with ACL rupture, making posteromedial portal in all those who had some degree of instability in the posterior horn of the medial meniscus. They found a 9.6% prevalence of injuries on the ramp among all patients with ACL injuries.…”

Section: Reconstruction Of the Anterolateral Ligament And Repair Of Tmentioning

confidence: 99%

Return to Play After Anterior Cruciate Ligament Reconstruction

Goes

Cossich

França

et al. 2020

Rev Bras Med Esporte

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The anterior cruciate ligament (ACL) tear represents more than half of all knee injuries in sports that involve body rotations and sudden changes of direction. Discharging the athlete for return to play (RTP) post-ACL reconstruction (ACLR) is a difficult task with multidisciplinary responsibility. For many years, a six-month period post-ACLR was adopted as the only criterion for RTP. However, it is now suggested that RTP should not be exclusively time-based, but to clinical data and systematic assessments. Despite the importance of post-ACLR factors for RTP, pre- and peri-ACLR factors must also be considered. Historically, ACLR is performed with the hamstring or autologous patellar tendons, although the choice of graft is still an open and constantly evolving theme. Anterolateral ligament reconstruction and repair of meniscal ramp tear associated with ACLR have recently been suggested as strategies for improving knee joint stability. Subjective questionnaires are easy to apply, and help identify physical or psychological factors that can hamper RTP. Functional tests, such as hop tests and strength assessment by means of isokinetic dynamometers, are fundamental tools for decision making when associated with clinical evaluation and magnetic resonance imaging. Recently, the capacity to generate force explosively has been incorporated into the muscle strength assessment. This is quantified through the rate of torque development (RTD). Due to characteristics inherent to the practice of sport, there is an extremely short time available for produce strength. Thus, RTD seems to better represent athletic demands than the maximum strength assessment alone. This review investigates the pre-, peri- and post-ACLR factors established in the literature, and shares our clinical practice, which we consider to be best practice for RTP. Level of evidence V; Specialist opinion.

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Correlation between time from injury to surgery and the prevalence of ramp and hidden lesions during anterior cruciate ligament reconstruction. A new diagnostic algorithm

Cited by 27 publications

References 5 publications

The popliteomeniscal fascicles: from diagnosis to surgical repair: a systematic review of current literature

The popliteomeniscal fascicles: from diagnosis to surgical repair: a systematic review of current literature

Anatomic risk factor for meniscal lesion in association with ACL rupture

Return to Play After Anterior Cruciate Ligament Reconstruction

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